自体骨髓间充质干细胞复合壳聚糖／羟基磷灰石支架修复兔膝骨软骨缺损  

Repair of articular osteochondral defects with composite bone marrow derived mesenchymal stem cells and chitosan/hydroxyapatite bflayered scaffold in rabbits

作　　者：王文良[1] 张华亮 初殿伟[3] 王彦鹏[1] 周洲[1] 王景贵[1] 

机构地区：[1]天津武警医学院附属医院骨科,300162 [2]武警九江市支队卫生队 [3]武警天津总队医院骨科

出　　处：《中华骨科杂志》2009年第1期61-64,共4页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金（30740089）

摘　　要：目的探讨骨髓间充质干细胞（bone mesenchymal stem cells，BMSCs）复合壳聚糖（chitosan，CS）／羟基磷灰石（hydroxyapatite，HA）支架修复兔膝关节局部骨软骨缺损。方法选健康日本大耳白兔36只，2--3月龄，体重1．7--2．0kg，每只抽取自体骨髓4--6ml，体外分离培养BMSCs后以2×10^7／ml密度植于CS／HA支架上体外培养10h，制成BMSCs-CS／HA支架复合物。将36只实验动物手术制成右膝股骨外侧髁负重区骨缺损模型后，随机分成A、B、C3组，每组12只。A组植入BMSCs-CS，HA复合物，B组植入单纯CS-HA支架；C组不作任何植入，为空白对照组。分别于术后6周、12周各处死6只动物，取材后进行大体、组织学观察.根据改良Wakitani评分标准进行评分，评估软骨组织的修复情况，并行成组设计方差分析。结果A组术后6周即可重建关节软骨缺损；修复软骨在观察期内逐渐变厚，软骨下骨有少量骨修复；术后12周透明软骨样修复，表面光整，与周围软骨色泽相近，软骨下骨有部分修复。而B组和C组12周时缺损区仍为纤维软骨样纤维组织修复，色泽浅黄。术后6、12周各组组织学半定量评分显示：股骨髁负重区修复A组评分明显优于B、C组（F=27．26，P〈0．05）。结论自体BMSCs复合CS／HA支架在体内环境下可形成透明软骨修复兔膝关节负重区骨软骨缺损。Objective To evaluate the results of the treatment of osteochondral defects on the femoral condyles by using autologous bone mesenchymal stem cells （BMSCs） combined with chitosan/ hydroxyapatite （CS/HA） bilayered scaffolds in rabbit knee joints. Methods BMSCs derived from Japanese white rabbits aged 2-3 months weighting 1.7-2.0 kg were cultured in vitro with a density of 2×1067/ml and seeded onto CS/HA scaffolds. The BMSCs-CS/HA complex was cultured for 10 h and transplanted into the osteochondral defects on the femoral condyles. Thirty-six knees with osteochondral defects created in the femoral condyles were treated （A） by BMSCs combined with CS/HA scaffold, （B） by simple CS/HA scaffold or （C） left untreated, respectively. Six rabbits were sacrificed at 6 and 12 weeks after operation in each group, and the reparative tissue samples evaluated grossly, histologically according to the gross and histological scale. Results The treatment of CS/HA scaffolds improved defect filling compared with that left untreated, while the regenerated tissue was mainly fibrocartilage and showed little bone formation. When implanted with CS/HA scaffold combined with BMSCs, most of the defects were filled with a well-established layer of cartilage tissue with a little bone formation observed by HE staining and toluidine blue staining. Conclusion The BMSCs combined with CS/HA scaffolds to repair osteochondral defects on the femoral condyles is a promising approach for the treatment of osteochondral defects.

关 键 词：间质干细胞 壳聚糖 羟基磷灰石类 组织工程 

分 类 号：R686[医药卫生—骨科学]